Laserfiche WebLink
� CT�ECg pFF i,IST FOR XSSUANCE aF �E���'S <br /> �OR OFFICE USE ONLZ'� � <br /> ,; <br /> �DDRESS �R LE%AL: " <br /> ov��^ar� '=( <br /> PID: RK: � v�. _, �r�� . � c lC c� ,�.> �� <br /> 7�ESC��P'I`� �i OF WO % t,. k - <br /> � � � ��,�._t �,;y_e:..l=_ v�_�z�„�k-=ss�=--��_ t,,c:_.�------------------- fdAc� <br /> _.,�.¢1�... - � � C�2C�C <br /> _�___--------- ----- � <br /> ZOVI�IG REVTE'�V BX: 37ATE APP�OVED: Z <br /> BUILDING REVTE�V BY: - . . <br /> DATE APPROVED: �-y -�n � . scr����� <br /> ____ --=------=-- __-_ =--=-----------------------=----------------------------a�<<��,�{,� <br /> �`EES TO BE CHA�2GEA: Misc. Fezs Calculated By: �(�C(L <br /> PERIviIT Yes :/, No <br /> PLAN REVIEtiV � Yes r/ , No SE�YER CONNECTION <br /> No tiVATER CONNECTION <br /> STATE SURCHAR.GE �-'eS � No � pARK FEE <br /> INVESTIGATION FEE Yes No � STTETNSPECTION <br /> SAC Yes <br /> OTHER (specify) <br /> Number of SAC�Units _ ______________________ <br /> ------------------�___------ <br /> ---------------------------- C � <br /> �,Oiy-T��C� CH�CK LIST' Zoaing District: � <br /> Post Office: School District: � <br /> Fire Department: , � r <br /> �. 1 <br /> L.ot Area: Sq.ft. Acres� i O�� W idch C 70 �- Depth .�- <br /> Survey Submitted: Yes � <br /> �o Date of Survey: ;Z1___r Z��"� R'�'`' l� <br /> LJ r1 a"�(�'"�'� .^�.t-� � <br /> Proposed Setbacks`. <br /> Froa[(�.ake): I'1�} Rd�stSide: �-� - . <br /> . `lV"i�' n <br /> P.ear ( reet): ��'� � �Side: �I E� <br /> �'1 3r.P�f Stntri_�i7ZS' ✓��G� �vPt�?�T�: �I�.ti'i�. �c. �,���. ,�ti'�� <br /> J <br /> auilding Heig,ht: DeE. Hgt. ��1��' Peal`hg�. <br /> Lot Covera�e: �':-=`� � tc, c>:(� � <br /> � <br /> Gradin�; Staff Approvzl Date: <br /> ����, By; CouncL Approval Date: <br /> Septic: Staff Approv� Date: �'\ ' �y: � � <br /> 7oa+n� F�az� � <br /> Resolutioa: n___ Resol�cion Date: <br /> IS �n ��� � v�c;�- f c-v��� ��-:�u�,c��. :.le_�k_(�c.-.�c�� �S <br /> Sho:eta.nd Distric�: � ��Covecz�e: <br /> �vg. Setbac'o-:: B!�Er;Setback: <br /> �`�t�a Proposec� <br /> H�eco��er: G-7�' <br /> 7�-2�Q' <br /> 2���-��.�:;' - <br /> �C��-iG��' <br /> n� _��. 1'p- �`n .�_._ 0. �llt_-�. nv_ .. �. <br /> {--�]'�;.����i'C: .� Z'�.'.� . tiL�._�._. � <br /> �; , , T-� ('n 17��'��1: � rQ"i1�S i,c.wr_�/�ti,�.� �1�//�w�l��i7 � <br /> n o•J �"'l��6"Z "i P l� <br /> �.�l�L-��.�� ,.L_ <br /> l;2 �55��/ v,v (��✓���.�`�J , ,_ ____ <br /> ! �. -- <br /> ----- <br />